Uh oh: Obamacare author warns implementation could be a “train wreck”

posted at 4:01 pm on April 17, 2013 by Mary Katharine Ham

Senate Finance Committee Chairman Max Baucus, one of the health reform law’s chief authors, says he’s worried about a “huge train wreck coming down” if the Obama administration doesn’t improve its public outreach about the legislation.

Baucus, a Montana Democrat who is up for reelection in 2014, sharply criticized the administration’s outreach efforts in a budget hearing on Wednesday. He told Health and Human Services Secretary Kathleen Sebelius that people and businesses “have no idea what to do, what to expect” from the law.

“If the administration implements it correctly, millions more Americans will gain access to health care next year,” Baucus said. “I am concerned that not every state, including Montana, will have an insurance marketplace established in time.”

After the hearing, Baucus explained that the train wreck is “that consumers and businesses will just not have enough information. That it will be too confusing.”

He also expressed frustration that the White House and HHS are not providing details of its outreach efforts.

Baucus is actually addressing three separate problems in his criticism—a messaging problem and two logistics problems— but making it sound in his clarification as if he only means there’s a messaging problem, which is the Obama administration’s standard line for most of its failures.

This is more than a messaging problem, as Baucus himself clearly indicates. He has concerns that Montana and other states will not have an insurance exchange in place by October, when the public is supposed to begin open enrollment.

As HotAir pointed out in November, the danger of delay stems from the fact that the administration foolishly assumed every state would build their own exchanges, though it had not given states requisite incentive, information or regulations around which to build these complex systems. The reason the Obama administration did not roll out most of the exchange regulations until late 2012 is because being explicit about the bill’s new requirements would have been unhelpful to the president’s reelection. Baucus and Co. leaving most of the regulations blank for Sebelius’ regulators to fill in had the same political calculus behind it. But the administration’s delay, as even Joe Klein concedes, was irresponsible and may spell big trouble for exchanges.
Another complaint also goes beyond messaging and outreach. He asked Sebelius about the system’s “Navigators”—a customer service army meant to smoothly and competently guide citizens through the process of applying for Obamacare and buying health care through exchanges. Now, even if you set aside the federal government’s reputation for customer service, it would take a tremendous amount of time and savvy to train all these employees in the intricacies of the federal data hub, the complicated formula for determining subsidies, and the technological interface for exchanges, most of which does not yet exist.

“My main concern is that when I ask them for information about the navigators … that I don’t get anything back,” Baucus told reporters.

Sebelius defended the administration’s efforts, arguing that there will be navigators — guides to help consumers through the exchanges — ahead of the Oct. 1 enrollment date. Sebelius also said that people will be in the states this summer to inform people about the law. She said HHS officials and the Small Business Administration are holding webinars and seminars and will be holding more through the summer.

But when Baucus asked for the number of people and which states, Sebelius declined to reveal specifics.

Emphasis mine. Here’s a bit of data I have from Maryland. Baucus is right. Continued promises and concepts, no matter how good they sound, don’t help us determine whether this thing can get off the ground.

I like to use Maryland as a benchmark for how exchange implementation is going. In order to be fair, I’ve picked the state with arguably the highest health-care-bureaucrat-to-citizen ratio and a lot of experience heavily regulating health care. Maryland was also politically gung-ho from day one to implement Obamacare. When I tell you where Maryland is in the process, you can safely assume almost every other state is behind it.

In addition, the state is hiring companies that will create and/or manage parts of the exchange. When their contracts are finalized, the companies will do their own hiring for a so-far undetermined number of jobs.

“A lot of our resources will be through vendors,” says Leslie Lyles Smith, the exchange’s director of operations, of the companies to which the exchange will subcontract various responsibilities.

Smith says that most of the future employees, both those hired by the exchange and by vendor/subcontractors, will be in operations and IT. She divided the job areas into the following categories:

Emphasis mine again. At meetings of the Maryland Health Benefit Exchange board, state officials have indicated training for Navigators would take several months. So, Baucus is not just encountering a problem of Navigators who are not getting the word out, but Navigators who do not yet exist.

“Sebelius said there will be no polling, testing or benchmarks to measure how much people know about the law,” Politico notes. If you’re wondering whether smaller, state-level reforms in health care generally have polling, testing, pilot programs, and benchmarks for this kind of thing, yes they do. The administration’s messaging strategy is no doubt hampered by the fact that it must solve pretty serious technical and logistical problems before it can tell anyone anything. Both the magnitude of the program and the administration’s own foot-dragging have exacerbated the problem. Pretending it’s one that can be fixed with mere better messaging will not help fix it. You can repeat, “It’s like a Travelocity for health care” as many times as you like. That won’t build a Travelocity for health care.

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An Ass masquerading as a President once found a Doctor’s white lab coat which had been left out in the sun to dry. He put it on and spoke to his countrymen. All bowed, both men and women, and he was a proud Ass that day. In his delight he lifted up his voice and brayed treatments and prescriptions randomly and incoherently and unleashed mindless and thirsty bureaucrats upon the land and then everyone knew him for what he really was.

I would expect the health care Navigators when hired to be as helpful, courteous and friendly as your average big-city Department of Motor Vehicle Navigator. So even if they get the spots filled, this isn’t going to solve ObamaCare’s public relations problems.

You guys are soooooooo negative. Why just this morning I was discussing with a few friends how truly wonderful it will be to finally have free healthcare for all. My leprechaun buddy is a little worried about whether or not his unicorn will be covered though.

Employers know exactly what is coming and they are planning for it. Your employer based premium costs are getting ready to explode, especially for family coverage – if they choose to provide it which I believe the act says you do not have to do.

And where does your family go? To the exchanges!! Which are… NOT DONE and won’t be for 2014. We have an excellent chance to have more people uninsured than when we started this trip.

This is a train wreck – and it has every opportunity to cost the dems the senate much as it cost them the house in 2010.

If Thomas More weren’t already dead I’d kill him! Utopia doesn’t exist! Life is inherently unfair. If you work hard and have a decent job you will have decent healthcare. If you are a slacker, boozehound, drug addict, loser, perpetual victim then chances are you won’t have good healthcare. Guess who the Dems based Obamacare on? The big joke is that these loinfovos think their costs will be going down, that they will get to keep their doctor, that a Utopian medical world is just months away. They are in for a rude awakening. I would experience schadenfreude except they are dragging me and the majority of good, hardworking Americans down with them. Spit!

Gee…when they found out ‘what’s in it’ … they decided they don’t want it after all.

I’m so tired of being in the ‘I told you so’ position with the LEFT.

IF they ever learn to think things through, do the research to understand what they’re actually talking about, and realize that they don’t know what’s best for everyone else… they may begin to act and think like rational, adult, mature human beings.

But will the public know or care?
Guessing there is a huge number of welfare/foodstamps/disability and wannabe’s that figure the govt. will add on free Obamacare to the other handouts…
so they will vote Democrat the next time around.

He could give a crap about the American People, all he’s concerned with is re-election. When this is exposed as a total cluster f*@&k, (to all those that haven’t been paying attention)he might lose his job. But not to worry, because he and all his A-hole senate buddies have an awesome health plan till the day they die. F them all!

FYI – Yesterday I got an email from Blue Shield saying that since I had kept the same health insurance plan since before March 2010, I was “grandfathered” and could keep my same health insurance plan after Obamacare goes into effect.

The cost of the plan has almost tripled since Obamacare passed, but if I am willing to continue to pay $900+ per month for my individual (1 person) plan I can keep it.

I haven’t figured out yet, if this will be a better deal than getting health insurance via the “exchange” that includes all of the Obamacare bells and whistles.

Max “cram down” Baucus can rot in hell for all I care. Allow me to take you all on a trip down memory lane:

Top aides to Senate Finance Chairman Max Baucus (D-Mont.) called a last-minute, pre-emptive strike on Wednesday with a group of prominent Democratic lobbyists, warning them to advise their clients not to attend a meeting with Senate Republicans set for Thursday…

“They said, ‘Republicans are having this meeting and you need to let all of your clients know if they have someone there, that will be viewed as a hostile act,’” said a Democratic lobbyist who attended the meeting.

and…

The stated purpose of Thursday’s meeting, organized by Sen. John Thune (R-S.D.), is to discuss proposals for how to pay for health care reform. …

Thune said Democrats are using threats and intimidation to keep unhappy stakeholders silent.

“If you don’t engage on this thing, this train’s leaving the station,” Thune said. “If you want [Republicans] to have more influence, you’ve got to engage.”

It doesn’t matter. The GOP is in surrender mode and they are about to push through an enormously complex and flawed immigration bill similar to what was done with healthcare. Nothing is getting fixed. We are just expanding government with more bureaucracy, more regulation and more spending.

Good. It’s the only thing that gives me political joy is to watch libtard dreams coming crashing down under it’s weight and no thanks to the traitorous GOPe who even now scurry in the shadows to help the donks save their dreams.

Public outreach isn’t problematic for Obama. The legislation outright sucks and was slapped together by moronic liberal apparatchiks who have no clue about the Constitution or health insurance. Gee, who’da thunk it?

Just round up a bunch of Obama butt-kissers in lab coats to tell low-information nimrods how great it is. Where’s my free insurance?

So, in other words, the Democrats in Washington are beginning to realize that the Obamacare they shoved down our throats and crowed in our faces about is about to land on their heads like Thor’s hammer.

Immigration will not pass either – the populace (dem and GOP) don’t want it.

Zomcon JEM on April 17, 2013 at 5:04 PM

It won’t pass if the public finds out what is actually in it.

So we know the MSM will do everything possible to prevent that from happening.

In fact, the WSJ got an early start today, claiming in an article that the immigration bill limits chain migration. In fact, the bill increases chain migration, and expands the definition of “immediate family” so that even more family members (of newly-amnestied illegals and other immigrants) can be brought into the U.S.

Once again, it’s supposed to be a train wreck, one that brings the last remnants of a private insurance/healthcare system down with it so that government single payer can come riding to the rescue.

jnelchef on April 17, 2013 at 6:08 PM

You know, I’m not so sure it’s going to work the way they’d hoped. I think they were hoping for a gradual push to move toward single payer as the law made more and more companies drop coverage. Crash and burn on opening day is not necessarily going to get a majority of Americans (who already oppose the law) to buy into the notion that the only fix to a gigantic government f***-up is a gigantic government solution. The way it was before Obamacare will be too fresh in everyone’s minds.

That’s my hope. If Republicans were smart (okay, stop laughing), they’d already be writing the ads to take advantage of the collapse.

I heard somewhere that the “Navigator” staff would be a massive hire of union members (SEIU?) and be paid $25 to $40 per hour to guide citizens though the massive maze to pre-qualify, and (maybe) obtain their healthcare.

I know people with masters degrees making $40/hr., so I guess these people will have a similar education requirement, no? (/sarc)

An Ass masquerading as a President once found a Doctor’s white lab coat which had been left out in the sun to dry. He put it on and spoke to his countrymen. All bowed, both men and women, and he was a proud Ass that day. In his delight he lifted up his voice and brayed treatments and prescriptions randomly and incoherently and unleashed mindless and thirsty bureaucrats upon the land and then everyone knew him for what he really was.

So Max does not want to be blamed for this? How touching and yet so ironic! The author of this mountain of crap.

Navigators? Really? Can you imagine having these bright-eyed and bushy-tailed concierges taking you through the (impossible) enrollment process? No – they will be union drudges with only a vague idea of their role and no interest or competence with the matter at hand.

Why doesn’t Max rely on her highness HHSS Sibileus whose decsion in all healthcare matters is not subject to review or appeal.